Buprenorphine treatment in an urban community health center: what to expect.
BACKGROUND
Despite new opportunities to expand buprenorphine treatment for opioid dependence, use of this treatment modality has been limited. Physicians may question their ability to successfully treat opioid-dependent patients with buprenorphine in a primary care setting. We describe a buprenorphine treatment program and treatment outcomes in an urban community health center.


METHODS
We conducted retrospective chart reviews on the first 41 opioid-dependent patients treated with buprenorphine/naloxone. The primary outcome was 90-day retention in treatment.


RESULTS
Patients' mean age was 46 years, 70.7% were male, 58.8% Hispanic, 31.7% black, 57.5% unemployed, and 70.0% used heroin prior to treatment. Twenty-nine (70.7%) patients were retained in treatment at day 90. Compared to those not retained, patients retained in treatment were more likely to have used street methadone (0% versus 37.9%) and less likely to have used opioid analgesics (54.6% versus 20.7%) and alcohol (50.0% versus 13.8%) prior to treatment. Of the 25 patients with urine toxicology tests, 24% tested positive for opioids.


CONCLUSIONS
Buprenorphine treatment for opioid dependence in an urban community health center resulted in a 90-day retention rate of 70.7%. Type of substance use prior to treatment appeared to be associated with retention. These findings can help guide program development.
Cunningham
Chinazo
C
Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY 10467, USA ccunning@montefiore.org
Giovanniello
Angela
A
Sacajiu
Galit
G
Whitley
Susan
S
Mund
Pamela
P
Beil
Robert
R
Sohler
Nancy
N
D002047:Buprenorphine / Q000627:therapeutic use*; D003153:Community Health Services / Q000458:organization & administration*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009270:Naloxone / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000188:drug therapy; D019037:Urban Health Services / Q000458:organization & administration*
D009292:Narcotic Antagonists; D009270:Naloxone; D002047:Buprenorphine